Clause 10 - Assessment of a carer’s needs for support

Care Bill [Lords] – in a Public Bill Committee am 9:30 am ar 14 Ionawr 2014.

Danfonwch hysbysiad imi am ddadleuon fel hyn

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People) 9:30, 14 Ionawr 2014

I beg to move amendment 84, in clause 10, page 9, line 41, after ‘adult’, insert

‘or an individual under the age of 18 with caring responsibilities’.

Members of the Committee will know that clause 10 relates to family carers’ needs for support. The amendment would extend the right to have a carer’s assessment to young carers to ensure consistency with the changes that the Government propose to the Children and Families Bill. We welcome the fact that the Government have finally agreed to amend that Bill to extend the right to an assessment to young carers aged under 18. Young carers will no longer have to request an assessment or be undertaking a regular and substantial amount of care. We also welcome the fact that the Government have agreed to develop what they call a whole-family approach to assessments and support in both the Children and Families Bill and this Bill so that young carers’ needs are included when assessing an adult’s needs for care and support.

As the Minister will be aware, Opposition Members and some Government Members have consistently pressed the Government to make these changes. I want to pay a huge tribute to the work of the National Young Carers Coalition, the Carers Trust and Carers UK for their tireless efforts on this issue. Amendment 84 would ensure that changes in the Children and Families Bill to ensure that young carers’ needs are assessed are mirrored in this Bill to make it crystal clear what local authorities’ responsibilities are in this area and to ensure absolute consistency.

There are an estimated 700,000 young carers in Britain with an average age of 12; some are as young as eight or nine. Caring can put a huge strain on these young people. It can rob them of a normal childhood. It can disrupt their education and have a serious effect on their health and later life chances. This issue has been raised many times before on the Floor of the House and it is important that we also reflect it in Committee today. Nearly one third of young carers in secondary school have educational difficulties or miss school because they have to look after or help to look after a parent. Many feel isolated when they are growing up.

School staff are often unaware that students are carers so it can be a hidden cause of underachievement. Many young carers leave school with no qualifications. They are less likely to be aware of their rights and to understand or be aware of the information, advice and support that is available. Later in the Committee, we will return to our amendments that seek to put a clear duty on local authority children’s services to identify and support young carers, by working with schools and higher and further education institutions—colleges and universities—in particular, to ensure that they have a specific duty to identify student carers. The Government have made progress on the issue, but a clear duty on schools, colleges and universities to identify young carers would make a big difference.

I pay tribute to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), who has been campaigning on the issue and has produced a private Member’s Bill. The amendment reflects what she has done in working with young carers’ organisations.

Photo of Debbie Abrahams Debbie Abrahams Llafur, Oldham East and Saddleworth 9:45, 14 Ionawr 2014

I absolutely support what my hon. Friend says. I did some research with young carers. Their caring responsibilities impact hugely on long-term issues, particularly the development of relationships and long-term health needs, including their future as a whole. Making a change is absolutely vital.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

A big challenge in many areas of public service is to shift the focus to prevention. Ensuring that young carers get the support they need early on will have a big impact on them and their later life chances across a whole range of areas. The amendment would ensure that there is absolute clarity and consistency in both Bills.

I want to ask the Minister for further clarification on the whole-family approach that the Government say will be put in place by the combined changes under the Children and Families Bill and the Care Bill. I understand that more details of the whole-family approach to supporting young carers and the people they look after will be set out in forthcoming regulations.

I want to raise an issue that has been brought to our attention by the Carers Trust. It says that the regulations must make it clear that when there is a risk that a child or young person’s well-being would be negatively affected by their caring role, care and support should be delivered to the whole family in a properly co-ordinated way, genuinely looking at both needs together and having a package of support that meets the needs for care and support of both the adult and the young carer.

Who is working on the regulations in the Department of Health and the Department for Education? Will the Minister commit to ensuring that both Ministers work together and that, crucially, they work with the National Young Carers Coalition, the Carers Trust and Carers UK to ensure that the regulations and the guidance to councils are genuinely joined up? When will the regulations be published?

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

I am grateful to the shadow Minister for allowing me to intervene. I absolutely commit to close collaboration with the groups that she referred to and I join her in paying tribute to the campaigning work that they have done. There has so far been a fruitful collaboration in achieving the advances. In getting the regulations right, it is critical that that collaboration should continue, which of course has been the whole spirit of the legislation throughout.

To pick up on another of the hon. Lady’s points, there needs to be close collaboration between my Department and the Department for Education, so that officials can ensure that the two pieces of legislation marry up effectively and lead to the whole-family approach to which she refers.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

I am grateful to the Minister. When he rises to respond to the amendment, it would be useful to get a sense of the time scale. We really need to make sure that when guidance goes out to councils about everything in this Bill, the guidance on young carers is part of it. Otherwise, people will not start as they mean to go on; the Minister will know that the first bit of bumf they get about their new roles is what they will end up developing their work programme with. I am concerned that there might be a delay and want him to make sure that there is not. I will sit down now; the Minister can respond during his other comments if he likes.

Photo of Meg Munn Meg Munn Llafur, Sheffield, Heeley

I want briefly to support the amendment. I have the honour of being the patron of Sheffield Young Carers, so I have had the opportunity to speak to quite a few carers about their situation. They tell me that too often they are met by disbelief; teachers and other people do not believe them—“How can this young person take on this role? It is just an excuse for why their homework has not been done or they are late to school”. That disbelief does not stop with teachers, but spreads to people in social care. It is one of the effects of the separation of caring services for children and adults.

It is so long ago since I trained. I was a generic social worker so we did the whole lot, as it were. Even when we worked in separate teams—I was in children’s services—we worked very closely with our colleagues in adult services. However, as time has gone on, and for good reasons because there is greater specialisation, that split often means that those who work in social care with adults just do not have the children in their heads. They do not consider what is happening—the effect on the children of being in a household where somebody has significant needs or what they are doing. The approach of putting young carers into the Bill is important.

My hon. Friend the Member for Leicester West has said that the issue is important in relation to the information that goes out early on and the training to support the process, but it is also important in making a fundamental statement that young carers are important and that they also have needs as children that need to be met. They should not be seen as something separate.

I know it takes far more than words in legislation to achieve cultural change, but it is enormously important that there should be such change. There is much greater identification of young carers now than ever there was,  and we should take heart from the projects that have been run. In Sheffield, projects have been run about young carers in particular schools and those schools identify a far greater number of young carers than others. We can do a lot to improve the situation, but it is important that the issue appears in the Bill.

Photo of Paul Burstow Paul Burstow Democratiaid Rhyddfrydol, Sutton and Cheam

I want to underscore the point about the significant difference that the Bill will make for young carers. I thank the Government for listening to the lobbying and the recommendations of the Joint Committee.

I want to raise one issue that the Minister might be able to comment on: the interaction of the new duties around assessments of young carers and eligibility. We will come back to the issue later, but it is relevant here too. When it comes to eligibility, in some cases the assessment of a carer’s needs—in this case, a young carer’s needs—may well give rise to the identification of support needs for the person for whom they are providing care. However, that person may not themselves meet the eligibility criteria and may fall below the threshold.

As a consequence, the young carer continues to shoulder a disproportionate and unfair burden in what they have to do as a carer. Eligibility needs to be framed more subtly than it has been historically to take that into account, so that the threshold is personal and reflects the circumstances of the whole family. That issue is central to the design of eligibility. I hope the Minister will say something about that now or when we come to clause 13.

Photo of Bill Esterson Bill Esterson Llafur, Sefton Central

I echo the comments of my hon. Friends and the right hon. Member for Sutton and Cheam. It is important that we put children at the heart of all we do. In our lengthy debate in the Children and Families Bill Committee, we repeatedly returned to the importance of putting children first and ensuring that their needs are considered. I am glad that other Members have spoken about that.

In previous debates, the Minister has said that he does not like to legislate unnecessarily, and I hear that. However, we have been talking about the need to give guidance to councils. We can have the best intentions in tabling amendments, but the issue is the reality on the ground. Will the Minister spell out what the Bill will mean in practice and how it will improve not only the assessment of needs but their identification in the first place?

On Thursday, my hon. Friend the Member for Sheffield, Heeley talked about the reluctance of young carers to come forward to be identified and the fact that they are often not believed. Those are all important points. It would be helpful to know how the Minister thinks young carers can be identified and supported, what that will look like on the ground and what the practicalities are of what he intends.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

First, I confirm to the shadow Minister that we expect the draft regulations to be published for consultation in May. I repeat that we will collaborate with the Carers Trust and the National Young Carers Coalition in that ongoing work.

My right hon. Friend the Member for Sutton and Cheam said that the assessment of a young carer’s circumstances might identify the needs of the adult—perhaps a parent—for whom they are caring, and that  there needs to be sensitivity about their individual circumstances. I share that view. One of the longer-term pieces of work that we are doing, which he knows about because it was referred to in the White Paper, is to try to be more subtle and creative in how eligibility works in the long term. Of course, local authorities can choose to recognise the whole-family circumstance and the need for support for a parent, even if they do not meet the formal eligibility criteria.

I do not want the hon. Member for Sefton Central to get the impression that I am anti-legislation. I made the point last Thursday that passing something in this place does not always change the world; there has to be a combination of legislation and effective implementation. Sometimes legislation can do enormously good things and lead the way for changing cultures. The potential power of the Bill is that it will much more effectively recognise the vital need of young carers to be properly supported. The hon. Member for Oldham East and Saddleworth said that their needs are absolutely central. She or the shadow Minister made the point about teachers responding with disbelief—sometimes it can be even worse than that.

I met a young carer in my office, when Radio 1’s “Newsbeat” brought her in. She talked about how one teacher had been dismissive of her caring responsibilities; they were not really so important and homework came first. The teacher did not recognise the pressures that this 15-year-old girl was under, so there is an enormous need for a change of culture and for proper recognition of the need to support young carers. The changes that have been made are enormously important in advancing that cause.

The amendment extends the duty to assess carers to include a duty to assess young carers under 18. Furthermore, as the provision being amended provides the definition of carer for the purposes of the Bill—this is critical—it would, in effect, extend all the provisions in the Care Bill relating to carers, and adults caring for adults, to include young carers under 18. The Government have already amended the Children and Families Bill, putting a young carer’s entitlement to an assessment on a similar footing to the provisions in the Care Bill for an adult carer’s assessment so that the two pieces of legislation marry up properly.

The amendment to the Children and Families Bill consolidates and simplifies legislation relating to young carers’ assessments. The right to an assessment of needs is extended to all young carers under the age of 18 regardless of whom they care for, what type of care they provide or how often they provide it. I appreciated the shadow Minister’s welcoming the amendment, although she was a touch churlish in suggesting that we had finally accepted the case for amendment. There was, as I said, a good collaboration that resulted in a change and agreement to amend over last summer. It was widely welcomed by the groups campaigning on behalf of young carers, and I welcome her support for that and for the whole-family approach, which she also referred to in her contribution.

Photo of Meg Munn Meg Munn Llafur, Sheffield, Heeley 10:00, 14 Ionawr 2014

I understand the Minister’s concern about inadvertently widening the definition for the whole of the Bill, but can he say a little more about that? There is  genuine concern borne out of experience as well as talking to young carers. How will the Government ensure that the whole-family approach is adopted if it is not in the Bill? Will it be in the guidance that it refers across to the Children and Families Bill? How will it happen? Leaving it to good will and a general sense that this is what ought to happen is not enough.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

I hope that I can reassure the hon. Lady. The approach will absolutely be in the regulations that will be published in draft form in May. She and anyone else can respond to the consultation. I accept the points that she made in her earlier speech that too often these days within local authorities there is not good enough collaboration between social workers working on behalf of adults and those working on behalf of children. It is one of the perhaps unforeseen consequences of greater specialisation and of the creation of children’s services that bring education and children’s social work together; we have ended up with a bit of a divide between adults and children. That needs to be addressed.

The Government need to recognise the situation, and we are, through trying to marry up the two bits of legislation, but local authorities absolutely need to recognise it. Indeed, those who educate social workers need to recognise it, because if we are to make a whole-family approach a reality, all parts of the system need to work to achieve it.

Photo of Bill Esterson Bill Esterson Llafur, Sefton Central

The Minister mentioned education. Of course, local authorities do not have direct responsibility for what goes on in many schools. There is often difficulty in the relationship between different parts of local authorities and schools. Children spend large parts of their time in schools, and that is where these issues can best be identified. Can I push the Minister a bit further on how he sees that identification working in practice? He mentioned changing the culture, so that teachers and others believe children when they say they have caring responsibilities, so they can be assessed.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

I am grateful for that intervention. It is not always possible for Government to force things to happen but I agree that schools play a vital role in this. I have already referred to the duties of co-operation in the Bill. Schools need to work to identify where youngsters have caring responsibilities and be prepared to work with local authorities to achieve support for those youngsters, and to ensure that their caring responsibilities do not adversely affect their opportunities in education and later life.

I ought to press on. The amendment to the Children and Families Bill makes it clear to local authorities that they must carry out an assessment of a young carer’s needs for support on request or on the appearance of need, and provides the appropriate links between children’s and adults’ legislation to enable local authorities to align the assessment of a young carer with an assessment of an adult they care for.

In addition to that amendment to the Children and Families Bill, clause 12 of the Care Bill makes it clear that a local authority may combine an adult assessment with an assessment relating to a child, including a  young carer’s assessment, provided all parties agree. That, of course, helps to facilitate the whole-family approach.

The Government’s amendment to the Children and Families Bill about young carer’s assessments, together with the Care Bill provisions on combining assessments and the forthcoming regulations on a whole-family approach to assessing and supporting adults, provide a clear legislative framework to support local authorities to consider the needs of young carers and protect children and young people from excessive or inappropriate caring roles.

This amendment to the Care Bill would duplicate provision within the Children and Families Bill. It is one thing to have the two bits of legislation gelling well together, but there is no need for duplication when something is clearly provided for in one piece of legislation. I believe, therefore, it is unnecessary. Because of the extended role of the definition that I have referred to throughout the Bill it would be confusing to have similar provisions in both Bills. I hope, therefore, that the shadow Minister will agree to withdraw the amendment.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

I am grateful to the Minister for his response. I want to try to put this in its basic terms. If a social worker goes to assess a person who needs care and support and sees that they have children, those children are probably caring quite a bit for their parent. Does that social worker also conduct an assessment of the young carer, perhaps at a separate time?

We want to get the best results for the young carer, but we also want to avoid duplication. A social worker with generic skills can see the two people, do separate assessments and then bring them together. Unless we have something in the Bill that makes it clear to local authorities that, when they are assessing the adult they should also assess the young person—rather than doing it in a totally separate Bill focusing on children’s social workers—I am concerned that we will end up with duplication.

The Minister says that he does not want duplication in the Bill. I am more concerned about waste and duplication on the ground in reality and practice. It would make sense for a social worker with generic skills who could do both, to do that, but I am not yet clear that that would not be done by separate departments. I seek assurance from the Minister that that practical example will be addressed, rather than two separate work programmes and work streams going on in separate Government Departments and separate council departments. That is a practical issue to which I hope the Minister will respond.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

It is absolutely the intention for the two Bills to gel; for the regulations to develop the concept of the whole-family approach; and for the whole emphasis coming from Government, in terms of guidance and instructions to local authorities, to work on a whole-family basis.

Photo of Emma Lewell-Buck Emma Lewell-Buck Llafur, South Shields

May I press the Minister on his thinking about who would carry out the assessment? Would it be an adult social care worker, or a children’s social care worker? My worry is that a caring child could be lost in a battle of different departments saying, “Not my responsibility”.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

I completely agree with the hon. Lady that there is a risk of, “This is not my responsibility. It’s your responsibility”, and passing on to another department. It could be either, depending on the identified or apparent needs of a particular family.

The absolute need for those departments to work closely together and to make a reality of the whole-family approach is completely shared by both sides of the Committee. A clear and strong message goes out from both sides that that has to happen. The policy has to challenge some of the silos that have developed in social work and bring back the concept of looking at the whole family. As I said earlier, that has to be addressed in education as well as in provision of service.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

The issue is complicated. We do not want to make things more complicated than necessary, but we need to ensure that it is clear to people in practice who does what, and that we do not have two separate systems developing. I know that the Minister is committed to ensuring that that will not happen. I am grateful that he told us when the draft regulations are due to be published, and that he will continue to work with carers and young carers’ organisations. On that basis, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

I beg to move amendment 92, in clause 10, page 10, line 38, at end insert—

‘(10A) Where an adult is being assessed for NHS Continuing Care and this is to be provided in whole or in part in the community, and that person has a carer who is providing or about to provide care, the local authority must ensure that a carer’s assessment under this section and section 12 is carried out of the carer’s ability to provide or continue to provide care.’.

Photo of Andrew Rosindell Andrew Rosindell Ceidwadwyr, Romford

With this it will be convenient to discuss amendment 97, in clause 14, page 14, line 7, at end insert—

‘(3A) Services of an intimate nature can only be provided to the disabled person.

(3B) Regulations may make provision about what is, or is not, of an intimate nature for the purposes of subsection (3).’.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

As hon. Members know, clause 10 is about assessing carers’ needs for support. Amendments 92 and 97 are about assessing carers’ needs in two important areas. The first is in relation to NHS continuing care. The other is a separate issue, about ensuring that there is clarity in the Bill on the needs of families who are looking after someone, who often has a disability, and on ensuring that carers are not charged for the replacement service if they themselves need a break, and the person for whom they are caring needs to have care and support while the carer is having a break. I will go over the amendments and try to be as clear as I can, if that was not my most clear opening statement.

Amendment 92 seeks to ensure that carers of people who receive NHS-funded continuing care, rather than council-funded social care, do not fall through the gaps, and definitely get an assessment to ensure that their needs are met. Any hon. Member who has dealt with issues with constituents on NHS continuing care knows that it can be a nightmare.

There are often difficulties and rows between the NHS and councils about who should pay for someone’s needs, and family carers often fall through the gaps. If they are caring for someone who receives NHS continuing care, their own needs must be assessed by the council, but because the NHS is paying for the continuing care, that carer is often ignored. Our amendment seeks to ensure that even if care is NHS funded, a family carer will have the right to have their needs assessed and to receive support.

Carers UK raised the matter with us and it was discussed in the other place on amendments tabled by Baroness Pitkeathley, who has championed carers’ issues. It is important to clarity the matter, which is yet another area where two parts of the system do not work together. I hope the Minister will agree that the measure must be clarified to ensure that carers of people who receive NHS continuing care get the necessary assessments and support.

Amendment 97 relates to the wider issue of when family carers are charged for services and support. The Bill is trying to clarify charging, including if and when carers are charged for services and support. Carers UK is worried that it does not go far enough in defining when a service is for a user and when it is for a carer. For example, if a carer is struggling to look after someone and needs a break, they need that service as a family carer, but the person being looked after also needs a replacement service while the carer is on a break. Carers UK is worried that there is not enough clarity about that in the Bill. We do not want a carer to be charged not only for their own support but for the replacement service for the person being cared after. Carers UK is worried that the lack of clarity, particularly in relation to families looking after disabled relatives, could cause confusion among the people doing the assessments, the social workers and the councils in terms of their charging policies, and that there is a risk that carers could be increasingly and wrongly charged for services.

A related issue is my fundamental belief that disabled people must retain choice and control over the services they receive. There is a concern. If the carer needs a break and a replacement service needs to be put in place, we must ensure that the disabled person who receives that replacement service retains choice and control of what is happening to them. Our amendment seeks to ensure that disabled people retain that choice and control and are not simply given a service while their loved one is away. I am explaining this as clearly as I can.

Under the Carers and Disabled Children’s Act 2000, services provided to a disabled person to meet their carer’s needs, such as having a break, cannot include intimate services for the disabled person. That is what our amendment seeks to replicate. During the debate on clause 1, the Minister said that he was not sure whether the word “choice” added anything to the concept of individual control over day-to-day life. I am convinced that it does, and the amendment would entrench that in the Bill to ensure that disabled people continue to have choice in the services they receive.

I want to take this opportunity briefly to make a wider point about charging carers. There is provision in current legislation for councils to charge carers for services and support. However, in practice, many councils  do not use that power because they rightly understand that carers do a phenomenal job. They do so, as my hon. Friend the Member for Sheffield, Heeley said, because they are looking after someone they love, and that delivers a big saving to the taxpayer. Councils understand that, and many councils may not want to charge carers for such services.

I want to put it on the record that I was pleased to hear the debate in the other place, when Baroness Pitkeathley spoke about how Hertfordshire county council recently reversed its decision to charge carers: first, because it decided that if carers thought that they could not afford to pay the charge and gave up work, they would end up having to claim benefits, which would cost the local authority more; and, secondly, because it understood that many carers tend to be on lower incomes than other people of the same age, because they have had to give up work to take on their caring responsibilities, and so they would be unable to meet the charges levied on them. The concern, however, is that as local authority budgets are squeezed, councils will come under increasing pressure to charge carers for their services and support. According to the Health and Social Care Information Centre, 400,000 carer assessments were carried out in 2010-11. The Government’s own impact assessment for the Bill stated that the number of carers receiving an assessment after the Bill has been enacted is likely to go up by between 230,000 and 250,000.

The Joint Committee on the draft Bill—hon. Members will correct me if I am wrong—recommended that the Government protect carers from being wrongly charged. I understand that the Government have already attempted to meet that recommendation by amending clause 14. I hope that they will take a step further and provide complete clarity on ensuring not only that carers looking after someone who receives NHS continuing care are properly assessed by the council, but that they are not charged for the replacement services, as well as their own services in support.

I have attempted to explain that as clearly as I can. If I have not, I beg the Committee’s forgiveness.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health 10:15, 14 Ionawr 2014

Amendment 92 would impose a specific requirement on the local authority to assess the ability of a carer to provide, or to continue to provide, care of an individual who is being assessed for NHS continuing health care in the community. I am not convinced, however, that such a requirement is necessary.

I sympathise with the sentiment of the amendment, and I completely understand the concerns expressed by the shadow Minister. When someone is being considered for NHS continuing care, the risk is that the carer gets forgotten. That risk of course applies across the board, and we debated it last Thursday. There is a need for the whole system to be much more focused on the carer, as well as on the person being cared for.

It is important that no assumptions are made about a family member’s ability to care, or about an existing carer’s ability to continue to care, either by the NHS or by local authorities. If a carer is identified in the course of an NHS continuing health care assessment, the national framework for NHS continuing health care and NHS-funded nursing care makes it clear that the clinical commissioning group should: inform such carers about their entitlement to have their needs as carer  assessed; and, where appropriate, advise the carers either to contact the local authority or, with their permission, refer them to the local authority for an assessment. That directly addresses the concern expressed in the amendment.

Provisions in the Care Bill provide a lower threshold for a carer’s assessment than exist now. We propose to remove the existing requirement that a carer should be providing, or intend to provide, substantial care on a regular basis. Instead, the local authority will be required to offer a carer’s assessment where there may be a need for support. That is the only bar that needs to be cleared—a very low one.

Where the person whom the carer supports is being assessed for NHS continuing care and wishes their care to be delivered in the community, the local authority is likely to regard the carer as needing to be supported. A carer’s assessment would then be triggered. Clause 10(5) already requires a carer’s assessment to include an assessment of whether the carer is able, and likely to continue to be able, to provide care for the person needing care. Importantly, it also requires an assessment of whether the carer is willing, and likely to continue to be willing, to provide that care.

Nothing prevents a local authority from carrying out its assessments jointly with those being carried out by other bodies. Indeed, I encourage that approach and hope that the better care fund will shift things in that direction. We expect that to happen, and that approach would be entirely in accord with the co-operation requirement in clause 6. It will be helpful to consider that circumstance further as we work with stakeholders over the coming months on drawing up the regulations that will set out further provisions on assessments.

Photo of Grahame Morris Grahame Morris Llafur, Easington

Before the Minister moves to the next amendment, will he clarify whether he intends to use part of the better care fund to set up the infrastructure for assessment?

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

The better care fund sets out criteria on national conditions. There is a separate strand of funding in it for the preparation that local authorities will have to do to implement the provisions in the Bill.

Amendment 97 would introduce an unnecessary layer of regulation and potentially reduce flexibility in deciding how best to provide support. This is a complex area, and I do not entirely understand what the amendment seeks to achieve. That has nothing to do with the shadow Minister’s explanation, but it is not entirely clear, simply from looking at the amendment’s wording and its place in the clause, how it would work.

Meeting a carer’s needs will usually require providing some support direct to the carer, as one might expect. That may be in the form of a direct payment to allow the carer to purchase gym membership, or a laptop to keep in touch with others. However, depending on the circumstances and individual preferences, that may also include some type of care directly to the adult needing care, even though it is aimed primarily at the carer’s needs. I hope that the Committee is reassured that neither of the amendments is necessary and that hon. Members will feel able not to press them.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

I am grateful for the clarification on NHS continuing care, to which amendment 92 relates. I shall therefore be happy to withdraw the amendment. However, perhaps the Minister can clarify, first, whether a carer would be charged not just for their break, but for the service that replaces them when they are on their break. Secondly, when a council supplies that replacement service, will that adult—and especially disabled adults—still have the choice and control over that service? We do not want councils to supply replacement services that are not what that disabled person wants. Those are the two issues on which I wanted a bit more clarification from the Minister, either now or in a letter.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health 10:30, 14 Ionawr 2014

I am happy to write to the shadow the Minister to try to clarify all this further, but the carer would not be charged for care provided to the person they are caring for, to enable them to take a break or whatever it might be. In answer to the hon. Lady’s second question, I would want to ensure that the same degree of attention was paid to the individual’s needs and wishes, rather than any determination or assumption being made by others about what they need. That is at the heart of the Bill. I will happily write to her to expand and develop that point further.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

I am grateful to the Minister for that helpful clarification on those two points. I can imagine constituents coming into my surgeries worried about this if it is not absolutely explicit. It would be great if the Minister could write to me. On that basis, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 10 ordered to stand part of the Bill.